| Opas & Puangtong Jutabha | |
|
394 N Central Blvd Quartzsite AZ 85346-1499 | |
| (928) 927-5454 | |
| (927) 928-3303 |
| Full Name | Opas & Puangtong Jutabha |
|---|---|
| Speciality | Family Medicine |
| Location | 394 N Central Blvd, Quartzsite, Arizona |
| Authorized Official Name and Position | Puangtong Jutabha (OWNER) |
| Authorized Official Contact | 9289275454 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Opas & Puangtong Jutabha Po Box 1499 Quartzsite AZ 85346-1499 Ph: (928) 927-5454 | Opas & Puangtong Jutabha 394 N Central Blvd Quartzsite AZ 85346-1499 Ph: (928) 927-5454 |
| NPI Number | 1508048273 |
|---|---|
| Provider Enumeration Date | 12/04/2007 |
| Last Update Date | 04/20/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508048273 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 11915 (Arizona) | Secondary |
| 207Q00000X | Family Medicine | 11855 (Arizona) | Primary |
La Paz Regional Hospital, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 150 E Tyson Road, Quartzsite, AZ 85359 Phone: 928-927-8747 Fax: 928-927-8748 | |
Arizona Community Health Care Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 255 N Central Blvd, Ste 4, Quartzsite, AZ 85346 Phone: 928-927-4226 Fax: 928-927-4231 |